• Rabies risk behaviour in a cohort of Dutch travel clinic visitors: A retrospective analysis.

      Croughs, Mieke; van den Hoogen, Godelief A L; van Jaarsveld, Cornelia H M; Bantjes, Sabine E; Pijtak-Radersma, Atie H; Haverkate, Manon R; Swaan, Corien M; Ruijs, Wilhelmina L M (2021-06-11)
    • Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation.

      Suijkerbuijk, Anita Wm; Mangen, Marie-Josee J; Haverkate, Manon R; Luppino, Floriana S; Bantjes, Sabine E; Visser, Leo G; Swaan, Corien M; Ruijs, Wilhelmina Lm; Over, Eelco Ab (2020-09-01)
    • Rabiës PEP na slijmvliescontact.

      van Kessel, R; Schreuder, I; van den Kerkhof, H (2019-10-03)
    • Rabiëscasuïstiek in de GGD-regio Utrecht.

      van Dee, L; Dimmendaal, M; Bantjes, S; Haverkate, M; van Kessel, R (2018-09-18)
    • Radiation Protection for Interventional Fluoroscopy: Results of a Survey Among Dutch Hospitals.

      Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa (2018-06)
      A survey was conducted among 20 Dutch hospitals about radiation protection for interventional fluoroscopy. This was a follow-up of a previous study in 2007 that led to several recommendations for radiation protection for interventional fluoroscopy. The results indicate that most recommendations have been followed. However, radiation-induced complications from interventional procedures are still often not recorded in the appropriate register. Furthermore, even though professionals with appropriate training in radiation protection are usually involved in interventional procedures, this often is not the case when these procedures are carried out outside the radiology department. Although this involvement is not required by Dutch law, it is recommended to have radiation protection professionals present more often at interventional procedures. Further improvements in radiation protection for interventional fluoroscopy may come from a comparison of dose-reducing practices among hospitals, the introduction of diagnostic reference levels for interventional procedures, and a more thorough form of screening and follow-up of patients.
    • RADON AND THORON PROGENY IN DUTCH DWELLINGS.

      Smetsers, R C G M; Blaauboer, R O; Dekkers, F; Slaper, H (2018-09-01)
      Radon and thoron progenies in Dutch dwellings cause ~400 cases of lung cancer per year. Some 30% of the risk is due to thoron progeny, which demonstrates that the influence of thoron progeny is much larger than previously anticipated. This was concluded from a national survey in 2500 Dutch dwellings, built since 1930. Radon concentrations (15.6 ± 0.3 Bq m-3 on average) are correlated to type of dwelling, year of construction, ventilation system, location (soil type) and smoking behaviour of inhabitants. The survey data support the establishment of a comparatively low national reference level for radon in dwellings in the Netherlands of 100 Bq m-3, in line with recommendations by WHO and ICRP. Some 24 thousand of the 6.2 million dwellings in the Netherlands (built since 1930) are expected to exceed this level. Around 80% of these are located in the relatively small group of naturally ventilated single-family houses in two designated geographical areas. Radon concentrations above 200 Bq m-3 are rare in the Netherlands and simple and inexpensive measures will be sufficient to reduce enhanced radon concentrations to values below the national reference level. Thoron progeny concentrations (0.64 Bq m-3, on average) show correlations with year of construction and smoking behaviour. In 75 additional dwellings, a pilot study was conducted to determine the relationship between the exhalation of thoron from walls and the concentration of thoron progeny in the room. Thoron exhalation values exceeding the median value of 2.2 × 10-2 Bq m-2 s-1 by a factor 10 or more were found frequently, but enhanced concentrations of thoron progeny were measured only occasionally. Under very unfavourable conditions, however, for instance if phosphogypsum is applied as finishing material on all walls and ceilings in the house, strongly elevated thoron progeny concentrations may occur. This survey yielded a maximum recording of 13.3 Bq m-3. There is no reason to expect that such levels are specific to the Netherlands, indicating that in other regions with low radon levels, thoron may be a more important contributor to the population dose as well.
    • Raising awareness of false positive newborn screening results arising from pivalate-containing creams and antibiotics in Europe when screening for isovaleric acidaemia.

      Bonham, JR; Carling, RS; Lindner, M; Franszon, L; Zetterstrom, R; Boemer, F; Cerone, R; Eyskens, F; Vilarinho, L; Hougaard, M; et al. (2019-03-12)
    • Random effect modelling of patient-related risk factors in orthopaedic procedures: results from the Dutch nosocomial infection surveillance network 'PREZIES'.

      Muilwijk, J; Walenkamp, G H I M; Voss, Andreas; Wille, Jan C; Hof, Susan van den (2006-03-01)
      In the Dutch surveillance for surgical site infections (SSIs), data from 70277 orthopaedic procedures with 1895 SSIs were collected between 1996 and 2003. The aims of this study were: (1) to analyse the trends in SSIs associated with Gram-positive and Gram-negative bacteria; (2) to estimate patient-related risk factors for deep and superficial SSIs after all orthopaedic procedures, with special attention to primary total hip arthroplasty (THA); and (3) to analyse inherent differences in infection risk between hospitals. A random effect model was used to estimate the odds ratios of patient-related risk factors for developing an SSI, and to describe the distribution of the most widespread bacterial species responsible for SSIs among hospitals. Gram-positive organisms, mainly staphylococci, were the main cause of both deep (84.0%) and superficial SSIs (69.1%) after orthopaedic procedures. The percentage of SSIs after THA caused by coagulase-negative staphylococci decreased over the surveillance period, while the contribution of Staphylococcus aureus increased. Temporary elevations in the incidence of the most widespread pathogen species were observed within hospitals. Patient-related factors such as the National Nosocomial Infections Surveillance System risk index or age had little effect on the predictive power of the random effect models. This study underlines the usefulness of a random effect model, which adjusts risk estimates for random variation between hospitals, in a multicentre study on risk factors for SSIs.
    • A randomized crossover trial assessing time of day snack consumption and resulting postprandial glycemic response in a real-life setting among healthy adults.

      Timmer, Ruth; Bogaardt, Laurens; Brummelhuis, Walter J; van Oostrom, Conny T; van Kerkhof, Linda W M; Wong, Albert; de Valk, Harold W; Ocké, Marga C; van der Maaden, Tessa; Dollé, Martijn E T (2022-08-24)
    • Ranking Preventive Interventions from Different Policy Domains: What Are the Most Cost-Effective Ways to Improve Public Health?

      van der Vliet, Nina; Suijkerbuijk, Anita W M; de Blaeij, Adriana T; de Wit, G Ardine; van Gils, Paul F; Staatsen, Brigit A M; Maas, Rob; Polder, Johan J (2020-03-24)
    • Ranking uncertainties in atmospheric dispersion modelling following the accidental release of radioactive material.

      Leadbetter, SJ; Andronopoulos, S; Bedwell, P; Chevalier-Jabet, K; Geertsema, G; Gering, F; Hamburger, T; Tomas, JM; Twenhofel, C (2020-11-09)
    • Rapid and Robust On-Scene Detection of Cocaine in Street Samples using a Handheld Near Infrared Spectrometer and Machine Learning Algorithms.

      Kranenburg, Ruben F; Verduin, Joshka; Weesepoel, Yannick; Alewijn, Martin; Heerschop, Marcel; Koomen, Ger; Keizers, Peter; Bakker, Frank; Wallace, Fionn; van Esch, Annette; et al. (2020-07-07)
    • Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020.

      Reusken, Chantal B; Buiting, Anton; Bleeker-Rovers, Chantal; Diederen, Bram; Hooiveld, Mariëtte; Friesema, Ingrid; Koopmans, Marion; Kortbeek, Titia; Lutgens, Suzanne Pm; Meijer, Adam; et al. (2020-01-01)
    • Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

      Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik (2017-12-11)
      To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.
    • Rapid cross-border emergence of NDM-5-producing in the European Union/European Economic Area, 2012 to June 2022.

      Linkevicius, Marius; Bonnin, Rémy A; Alm, Erik; Svartström, Olov; Apfalter, Petra; Hartl, Rainer; Hasman, Henrik; Roer, Louise; Räisänen, Kati; Dortet, Laurent; et al.
      Whole genome sequencing data of 874 Escherichia coli isolates carrying bla NDM-5 from 13 European Union/European Economic Area countries between 2012 and June 2022 showed the predominance of sequence types ST167, ST405, ST410, ST361 and ST648, and an increasing frequency of detection. Nearly a third (30.6%) of these isolates were associated with infections and more than half (58.2%) were predicted to be multidrug-resistant. Further spread of E. coli carrying bla NDM-5 would leave limited treatment options for serious E. coli infections.
    • A rapid micro chamber method to measure SVOC emission and transport model parameters.

      Wang, Chunyi; Eichler, Clara M A; Bi, Chenyang; Delmaar, Christiaan J E; Xu, Ying; Little, John C (2023-03-10)
      Assessing exposure to semivolatile organic compounds (SVOCs) that are emitted from consumer products and building materials in indoor environments is critical for reducing the associated health risks. Many modeling approaches have been developed for SVOC exposure assessment indoors, including the DustEx webtool. However, the applicability of these tools depends on the availability of model parameters such as the gas-phase concentration at equilibrium with the source material surface, y0, and the surface-air partition coefficient, Ks, both of which are typically determined in chamber experiments. In this study, we compared two types of chamber design, a macro chamber, which downscaled the dimensions of a room to a smaller size with roughly the same surface-to-volume ratio, and a micro chamber, which minimized the sink-to-source surface area ratio to shorten the time required to reach steady state. The results show that the two chambers with different sink-to-source surface area ratios yield comparable steady-state gas- and surface-phase concentrations for a range of plasticizers, while the micro chamber required significantly shorter times to reach steady state. Using y0 and Ks measured with the micro chamber, we conducted indoor exposure assessments for di-n-butyl phthalate (DnBP), di(2-ethylhexyl) phthalate (DEHP) and di(2-ethylhexyl) terephthalate (DEHT) with the updated DustEx webtool. The predicted concentration profiles correspond well with existing measurements and demonstrate the direct applicability of chamber data in exposure assessments.
    • Rapid reinfection with SARS-CoV-2 variant-of-concern Alpha detected in a nurse during an outbreak at a non-covid inpatient ward: lessons learned.

      Koopsen, Jelle; Dekker, Mireille; Thung, Philip; Jonges, Marcel; Vennema, Harry; Leenstra, Tjalling; Eggink, Dirk; Welkers, Matthijs R A; Struijs, Peter A A; Reusken, Chantal; et al. (2021-09-26)
    • Rapid response screening for emerging zoonotic pathogens, barriers and opportunities: A study for enhanced preparedness of the Netherlands.

      Streng, Kiki; de Best, Pauline A; Timen, Aura; Koopmans, Marion P G; van der Poel, Wim H M; Sikkema, Reina S (2023-02-14)